{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Andrew K Hammann","gend":0,"currentgend":"","add":"4 HERITAGE LN","city":"FREEPORT","state":"ME","zip":"04032","dob":"1951-10-18","age":"","mstatus":"","insh":"10000051232","cliId":"","pno":2076073579,"cno":"","email":"SUSANHAMMANN363@HOTMAIL.COM","ename":"","eno":"","pphy":"KNIGHTON, BRIAN K","ppno":2078653491,"pcpadd":"42 MALLETT DRIVE,","pcpcity":"FREEPORT","pcpstate":"ME","pcpzip":"40326760","pcpcounty":"","pcpid":"","pcpname":"FREEPORT MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"4 HERITAGE LN","madd2":"","madd3":"","mcity":"FREEPORT","mstate":"ME","mzip":"04032","pcpfaxno":"","pcpnpi":1700824000,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2HN2YW1GK17","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R070","H18513","F3181","H26493","H16223","H903","B351","Z23","M2550","Z0000","E7849","K219","R7309","R6889","F4310","R45851","E871","F314","E878","F1221","Z5181","F5101","F331","H9190","F1210","Z136","F1020","F1220","H33312","R7301","M25569","R030","F1011","Z1211","F319","J189","Z87891","G4700","F3132","Z79899","R221","R5383","H59812","H43813"],"date":["2024-08-15","2023-12-11","2025-08-26","2023-12-11","2023-12-11","2024-08-15","2023-03-27","2025-06-23","2023-03-22","2025-08-22","2024-05-01","2023-03-27","2024-01-23","2022-12-19","2023-09-29","2023-09-30","2023-09-30","2023-10-24","2023-09-30","2024-03-19","2024-11-12","2023-11-16","2023-11-16","2023-11-16","2023-09-29","2025-08-13","2022-12-06","2023-09-05","2023-11-15","2024-12-13","2024-11-04","2023-09-30","2023-01-31","2024-05-01","2023-10-30","2025-01-08","2025-08-13","2023-09-29","2022-11-01","2022-10-11","2022-09-19","2022-08-17","2022-08-22","2022-08-22"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","LITHIUM CARBONATE ER","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LAMOTRIGINE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","PROPRANOLOL HCL","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","FREESTYLE LIBRE 3 PLUS SENSOR","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","XIIDRA","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","FLUARIX QUAD 2022-2023","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Assessment of Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"comment":[["","","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}